1981, 06-25 Permit: 81A-6321 FurnacePLAN NUMBEr.1APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
JOB ADDRESS
1. �`— l/—,?Ir LEGAL DESCRIPTION — SEE ATTACHED
LOT BLOCK SUBDIVISION PARCEL NUMBER/S
2.
OWNER PHONE
3.
A RESS Z P Actual Set Backs in Feet
`✓ f / h
North South East West
ONTR TOR PHONE Size of Parcel Zone Classification
4' A DRESS Z P e� Type Const. Occupancy Sprinklered
.' ❑Yes ❑No ❑ Req'd.
DE IGNER PHONE Valuation Building Area in Sq. Ft.
5. ADDRESS ZIP Main Floor Upper Floors Garage Area Storage
6. CHANGE OF USE FROM TO Area of Decks Finished Basement Unfin. Basement
'91
TYPENEW ❑ ALT. ❑ AD'N. RPL. ❑ MVE. No. Baths No. Stories No. Rooms No. of Dwellings
❑
7. OF ❑ OTHER
WORK ❑ BLD. ❑ PLMB. 5v1ECH, ❑ M.H. ❑ POOL CERTIFICATE Req'd. Recd. Not Req'd.
DESCRIBE WORK of EXEMPTION
! Enum. Dist. Location (Area)
$• Z ��1� ✓ �� ��/e FEES COLLECTED
VALUATIONSOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
OF /X`
9. UTILITIES Public ❑ Private ❑
Single $
1 hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not pre a Building
to give authority to violate or cancel the provisions of any other state or local law regulating constructi the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
DATE OF APPLICATION 1-1 --.1--7 -/1 " X1 SIGNATURE OF APPLICANT. "' Mech.
ann
re 7
—. —"•^� ^• ••�+�•+�-+ I ar Ca.rAL ,-U"JLJ.. RJNJ: /„/ — /
`
NAME DATE `IY L
eer
ns Exam
n PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE
Plan Check
SEPA
KPERRMMITT NUMBER It I
C *��
X320
c) 25—P1
6.479.
Mobile Home
Other (Specify)
TOTAL $ L'
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATE ISSUED PERMIT NO.
e
*1A0:0(OL F -j
TOTAL